ball-memorial-hospital-inc-v-l-gail-fair-as-personal-representative-of ( 2015 )


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  •                                                                  Mar 02 2015, 9:54 am
    ATTORNEYS FOR APPELLANT BALL                         ATTORNEY FOR APPELLEE L. GAIL
    MEMORIAL HOSPITAL                                    FAIR
    Edward L. Murphy, Jr.                                Laura J. Conyers
    William A. Ramsey                                    Findling Park & Associates, P.C.
    Murphy Ice LLP                                       Indianapolis, Indiana
    Fort Wayne, Indiana
    ATTORNEY FOR APPELLEES IZZET
    YAZGAN, M.D., AND MERIDIAN
    SERVICES CORPORATION
    Michael D. Conner
    Spitzer Herriman Stephenson Holderead
    Conner & Persinger, LLP
    Marion, Indiana
    ATTORNEY FOR AMICUS CURIAE
    INDIANA TRIAL LAWYERS
    ASSOCIATION
    Jerry Garau
    Garau Germano Hanley & Pennington, P.C.
    Indianapolis, Indiana
    IN THE
    COURT OF APPEALS OF INDIANA
    Ball Memorial Hospital, Inc.,                             March 2, 2015
    Appellant-Defendant,                                      Court of Appeals Cause No.
    18A02-1405-CT-316
    v.                                                Interlocutory Appeal from the
    Delaware Circuit Court
    L. Gail Fair, as Personal                                 The Honorable Marianne L.
    Vorhees, Judge
    Representative of the Estate of
    Suwanna Dickey, Deceased,                                 Cause No. 18C01-1001-CT-2
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015                   Page 1 of 19
    Appellee-Plaintiff,
    v.
    Izzet Yazgan, M.D., and
    Meridian Services Corporation,
    Appellees-Defendants.
    Bradford, Judge.
    Case Summary
    [1]   Suwanna Dickey was receiving treatment for mental health issues when she
    became acutely psychotic and was admitted to Appellant-Defendant Ball
    Memorial Hospital. While at Ball Memorial, Appellees-Defendants Dr. Izzet
    Yazgan and Meridian Services Corporation provided medical care and
    psychological services to Dickey. Initially, Dr. Yazgan prescribed Dickey
    Geodon and later switched to risperidone (a/k/a Risperdal). At approximately
    12:30 p.m. on April 12, 2008, Dickey died.
    [2]   In September of 2009, Appellee-Plaintiff L. Gail Fair, as personal representative
    of Dickey’s estate, filed a proposed complaint with the Indiana Department of
    Insurance. The proposed complaint named Ball Memorial, Dr. Yazgan,
    Meridian Services, and others as defendants. The proposed complaint alleged
    that Ball Memorial’s, Dr. Yazgan’s, and Meridian Services’ treatment of
    Dickey fell below the applicable standard of care. A medical review panel (“the
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 2 of 19
    Panel”) evaluated the evidence and arguments of the parties and unanimously
    decided that none of the defendants named in the proposed complaint breached
    the standard of care.
    [3]   In January of 2010, Fair filed her complaint in Delaware Circuit Court.
    (Appellant’s App. 7). All defendants filed motions for summary judgment, and
    in response, Fair designated an affidavit from Dr. Celestine M. DeTrana, who
    offered opinions criticizing Ball Memorial pharmacists. Fair also deposed Dr.
    Yazgan, whose testimony arguably suggested that Ball Memorial’s pharmacist
    breached the standard of care. Afterwards, Dr. DeTrana was deposed and
    testified that the pharmacist breached the standard of care.
    [4]   Ball Memorial moved for summary judgment, contending that Fair should not
    be able to pursue a medical malpractice claim against its pharmacist because
    such a claim was not made to the panel. Fair responded, contending that her
    failure to mention the pharmacist before the Panel should not preclude her from
    making the argument now. Dr. Yazgan and Meridian Services argued that,
    even if Fair is prevented from making a claim regarding the pharmacist, they
    should be able to raise such a claim as a defense. The trial court ruled that Fair
    would be able to pursue a claim against Ball Memorial’s pharmacist, and Ball
    Memorial now appeals. Because we conclude that (1) Fair may pursue a
    medical malpractice claim against the pharmacist, (2) Dr. Yazgan and Meridian
    Services may raise the pharmacist’s alleged negligence as a defense, and (3) Ball
    Memorial’s claim that its liability is limited to vicarious liability for the possible
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015      Page 3 of 19
    negligence of Dr. Yazgan and Meridian Services is not ripe for adjudication, we
    affirm.
    Facts and Procedural History
    [5]   In April of 2008, Dickey was receiving treatment for mental health issues when
    she became acutely psychotic. On April 4, 2008, Dickey’s family brought her to
    the Ball Memorial emergency department. (Appellant’s App. 141). While
    Dickey was at Ball Memorial, contractors Dr. Yazgan and Meridian Services
    provided medical care and psychological services to her. (Appellant’s App.
    167, 189-97). Records indicate that Dickey was given 20 mg of Geodon in the
    emergency room. (Appellant’s App. 142). In the morning on April 6, 2008,
    Dr. Yazgan issued a new order for a maintenance dose of 80 mg of Geodon
    twice per day. (Appellant’s App. 145). Dickey was admitted to Ball
    Memorial’s psychiatric unit on April 6, 2008. (Appellant’s App. 52). On April
    9, 2008, Dr. Yazgan discontinued Geodon and prescribed Dickey 3 mg of
    risperidone to be taken twice a day. (Appellant’s App. 150. At 3:24 a.m. on
    April 11, 2008, Dickey vomited. (Appellant’s App. 152). Dickey vomited
    again at 12:27 p.m. (Appellant’s App. 152). After seeing Dickey at
    approximately 1:00 p.m., Dr. Yazgan indicated that she should take 6 mg of
    risperidone at bedtime. (Appellant’s App. 153).
    [6]   On the morning of April 12, 2008, Dickey “vomited [a] moderate amount [of]
    brown liquid” and was given a small amount of Gatorade. Appellant’s App. p.
    154. Dickey’s scheduled morning medications were not given due to her
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 4 of 19
    nausea. (Appellant’s App. 154-55). Dickey was wakened for lunch, ate some
    gelatin, and drank some apple juice. (Appellant’s App. 155). Although the
    details differ somewhat in the different accounts, Dickey began vomiting
    profusely around midday and soon suffered respiratory arrest. Attempts to
    resuscitate Dickey were unsuccessful, and the time of death was listed as 1:23
    p.m., April 12, 2008. (Appellant’s App. 155-56). An autopsy determined that
    the primary cause of death was cardiac arrhythmia related to dehydration,
    which dehydration was possibly related to vomiting or inadequate fluid intake.
    (Appellant’s App. 158).
    [7]   On September 23, 2009, Fair, as personal representative of Dickey’s estate, filed
    a proposed complaint with the Indiana Department of Insurance. (Appellant’s
    App. 75). The proposed complaint named Ball Memorial, Dr. Yazgan,
    Meridian Services, and others as defendants. The proposed complaint alleged,
    in part, as follows:
    12. On and after April 6, 2008, Izzet Yazgan, M.D. and
    Meridian Services Corp. undertook the responsibility to provide
    counseling, medical and/or psychiatric services to Suwanna.
    13. The actions of Izzet Yazgan, M.D. and Meridian Services
    Corp. fell below the standard of care with regard to the treatment
    provided to Suwanna in that they:
    a.      Failed to properly evaluate, diagnose and treat
    Suwanna;
    b.      Failed to properly advise Suwanna with regard to
    her diagnosis and condition; and
    c.      Failed to properly monitor and supervise Suwanna
    while under their care.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 5 of 19
    14. On and after April 6, 2008, Ball Memorial Hospital, Inc.
    … undertook the responsibility to provide counseling, medical
    and/or psychiatric services to Suwanna.
    15. The actions of Ball Memorial Hospital, Inc. … fell below
    the standard of care with regard to the treatment provided to
    Suwanna in that [it]:
    a.     Failed to properly evaluate, diagnose and treat
    Suwanna;
    b.     Failed to properly advise Suwanna with regard to
    her diagnosis and condition;
    c.     Failed to properly monitor and supervise Suwanna
    while under their care;
    d.     The nurses and staff failed to properly administer
    medications and [monitor] the effects of the medication;
    and
    e.     The nurses and staff failed to properly assess,
    monitor and keep physicians advised of Suwanna’s
    condition.
    16. On April 12, 2008, Suwanna died as a direct and
    proximate result of the conduct of the Defendants.
    [8]   Appellant’s App. pp. 77-78. Fair’s submission to the Panel included, inter alia,
    a detailed statement of facts regarding Dickey’s final days and specific
    allegations of negligence by various defendants. Fair alleged that Dr. Yazgan
    breached the standard of care by (1) prescribing the maximum therapeutic dose
    of Geodon without adequate investigation of prior medication history or known
    counterindications; (2) increasing the risperidone dosage too rapidly; (3) failing
    to realize that Dickey was likely suffering from nausea as a side-effect of her
    intake of Geodon and/or risperidone, and (4) failing to diagnose or treat
    Dickey’s underlying depression. (Appellant’s App. 160-61).
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015    Page 6 of 19
    [9]    Fair alleged that other Meridian Services nurses breached the standard of care
    by (1) erroneously giving Dickey 80 mg of Geodon on April 8, 2008; (2)
    administering excessive dosages of risperidone without clarification of the
    medication orders and failing to appreciate that Dickey’s symptoms were
    caused be the excessive dosages; (3) failing to adequately perform an abdominal
    assessment on Dickey or check for dehydration; (4) failing to report abnormal
    laboratory results; and (5) perhaps not starting resuscitation efforts soon
    enough. (Appellant’s App. 160-64). Fair requested that the Panel render the
    opinion that “defendant, Ball Memorial Hospital, by and through its agents
    and/or employees, failed to comply with the applicable standards of care as
    charged in the plaintiff’s proposed complaint [and that] such malpractice was a
    factor in the damages suffered by Suwanna Dickey.” Appellant’s App. pp. 164-
    65. The Panel evaluated the evidence and arguments of the parties and
    rendered the unanimous opinion in May of 2012 that none of the proposed
    defendants breached the standard of care.
    [10]   Meanwhile, in January of 2010, Fair filed her complaint in Delaware Circuit
    Court. (Appellant’s App. 7). Following the determination of the Panel, various
    defendants filed motions for summary judgment. (Appellant’s App. 18). As
    part of her response, Fair obtained and designated a September 9, 2012,
    affidavit from Dr. Celestine M. DeTrana, who offered opinions that the
    defendants breached the applicable standard of care. (Appellant’s App. pp. 86-
    88).
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 7 of 19
    [11]   Fair deposed Dr. Yazgan on November 27, 2012. Dr. Yazgan testified that
    neither Ball Memorial’s pharmacist nor any other member of the
    pharmaceutical staff contacted him to clarify his medication order for Dickey.
    (Appellant’s App. 234-35). On March 11, 2013, the trial court scheduled the
    matter for trial, to begin on June 16, 2014. (Appellant’s App. 25). On April 10,
    2013, Fair deposed Registered Nurse Ina Dick, who explained how the
    pharmacy handled Dickey’s risperidone prescription. (Appellant’s App. 263-
    64). Dr. DeTrana was deposed on May 14, 2013. Dr. DeTrana opined that the
    Ball Memorial pharmacist breached the standard of care in Dickey’s case for
    failing to clarify what Dr. DeTrana believed to be inappropriate dosages of
    Geodon and risperidone. Appellant’s App. p. 130.
    [12]   On December 31, 2013, Ball Memorial moved for summary judgment and,
    alternatively, partial summary judgment, on the basis that, inter alia, Fair should
    not be able to pursue a claim that Ball Memorial’s pharmacist or pharmacy staff
    breached the duty of care because that argument had not been made to the
    Panel. (Appellant’s App. 59-72). Ball Memorial argued that (1) Fair designated
    no admissible expert testimony that any Ball Memorial employee breached the
    duty of care, (2) Fair could not pursue a claim based on negligence by the
    pharmacy staff, (3) Ball Memorial is not vicariously liable for any acts or
    omissions by Meridian Services or its employees, and (4) Ball Memorial is
    entitled to an order that any liability it could be found to incur would be
    vicarious and based on the alleged fault of Meridian Services.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015       Page 8 of 19
    [13]   On February 17, 2014, Fair responded to Ball Memorial’s motion for summary
    judgment, arguing that she should be able to pursue a claim against Ball
    Memorial’s pharmacist, claiming that (1) Indiana Supreme Court precedent and
    the Medical Malpractice Act allowed it, (2) she should be able to argue
    pharmacist negligence because she alleged in the proposed complaint that
    Dickey had been given an improper dose of risperidone, and (3) fairness
    dictated the she be able to pursue the claim because defendants raised it first.
    (Appellant’s App. 176-77).
    [14]   On February 27, 2014, the trial court held a hearing, after which it entered
    partial summary judgment in Ball Memorial’s favor, concluding that there was
    no factual dispute that the nurses who treated Dickey were employees of
    Meridian Services, not Ball Memorial. (Appellant’s App. 37-38). The trial
    court, however, denied Ball Memorial’s summary judgment on the issue of
    whether Fair could pursue a claim against the pharmacist, found that genuine
    issues of material fact existed on the question of Ball Memorial’s liability for the
    acts of Meridian Services, and declined to address the question of whether Ball
    Memorial’s liability (if any) is limited to vicarious liability for the acts or
    omissions of Meridian Services. (Appellant’s App. 39).
    [15]   Ball Memorial contends that (1) the trial court erred in denying it summary
    judgment because Fair may not pursue a claim based on the alleged negligence
    of the Ball Memorial pharmacist; (2) the trial court correctly concluded that the
    nurses whose care is at issue were not Ball Memorial employees; and (3)
    because Fair may not pursue any claims against any Ball Memorial employee,
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015      Page 9 of 19
    Ball Memorial’s potential vicarious liability is therefore limited to that incurred
    by Meridian Services. Fair argues that (1) the trial court correctly denied Ball
    Memorial’s summary judgment motion and Fair should be able to present
    evidence tending to show negligence by Ball Memorial’s pharmacist and (2) the
    trial court correctly declined to rule on the question of whether Ball Memorial’s
    potential liability is limited to vicarious liability for acts committed by Meridian
    Services. Dr. Yazgan and Meridian Services argue that (1) because there is no
    statutory requirement that they present possible defenses to the Panel, they
    should not be precluded from presenting evidence regarding possible negligence
    on the part of Ball Memorial’s pharmacist even if we rule in favor of Ball
    Memorial on its summary judgment claim and (2) any order relating to
    vicarious liability should be consistent with their right to present their defenses.
    Amicus curiae Indiana Trial Lawyers Association (“the ITLA”) argues that the
    Indiana Supreme Court has held that a plaintiff’s action in the trial court is not
    restricted by arguments made to the Panel and that authority from this court to
    the contrary should not be followed.
    Discussion and Decision
    Standard of Review
    [16]   When reviewing the grant or denial of a summary judgment motion, we apply
    the same standard as the trial court. Merchs. Nat’l Bank v. Simrell’s Sports Bar &
    Grill, Inc., 
    741 N.E.2d 383
    , 386 (Ind. Ct. App. 2000). Summary judgment is
    appropriate only where the evidence shows there is no genuine issue of material
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 10 of 19
    fact and the moving party is entitled to a judgment as a matter of law. Id.; Ind.
    Trial Rule 56(C). All facts and reasonable inferences drawn from those facts
    are construed in favor of the nonmoving party. Merchs. Nat’l Bank, 
    741 N.E.2d at 386
    . To prevail on a motion for summary judgment, a party must
    demonstrate that the undisputed material facts negate at least one element of
    the other party’s claim. 
    Id.
     Once the moving party has met this burden with a
    prima facie showing, the burden shifts to the nonmoving party to establish that
    a genuine issue does in fact exist. 
    Id.
     The party appealing the summary
    judgment bears the burden of persuading us that the trial court erred. 
    Id.
    I. Fair’s Claim Against the Pharmacist
    [17]   Ball Memorial contends that the trial court erred in declining to enter summary
    judgment in its favor on the question of whether Fair may pursue claims of
    negligence by Ball Memorial’s pharmacist. Fair argues that she should be
    allowed to present evidence of pharmacist negligence because she presented
    evidence of the administration of excessive dosages of Geodon and risperidone
    to the Panel; this court’s opinion in K.D. v. Chambers, 
    951 N.E.2d 855
    , 857 (Ind.
    Ct. App. 2011), trans. denied, disapproved on other grounds by Spangler v. Bechtel,
    
    958 N.E.2d 458
    , 466 n.5 (Ind. 2011), conflicts with the Indiana Supreme
    Court’s decision in Miller by Miller v. Mem’l Hosp. of S. Bend, Inc., 
    679 N.E.2d 1329
    , 1331 (Ind. 1997), and the Indiana Rules of Trial Procedure; and K.D. is
    distinguishable in any event. The ITLA also argues that K.D. is not good law
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015     Page 11 of 19
    but adds that the Panel’s opinion should not be limited to arguments made by
    non-expert claimants as a matter of policy.
    Background
    [18]   The Indiana Medical Malpractice Act (“the ACT”) governs medical
    malpractice claims against health care providers, with malpractice defined as “a
    tort or breach of contract based on health care or professional services that were
    provided, or that should have been provided, by a health care provider, to a
    patient.” 
    Ind. Code § 34-18-2-18
    . “[A]n action against a health care provider
    may not be commenced in a court in Indiana before … the claimant’s proposed
    complaint has been presented to a medical review panel established under IC
    34-18-10 (or IC 27-12-10 before its repeal); and … an opinion is given by the
    panel.” 
    Ind. Code § 34-18-8-4
    .
    (a) The evidence in written form to be considered by the medical
    review panel shall be promptly submitted by the respective
    parties.
    (b) The evidence may consist of medical charts, x-rays, lab tests,
    excerpts of treatises, depositions of witnesses including parties,
    and any other form of evidence allowable by the medical review
    panel.
    (c) Depositions of parties and witnesses may be taken before the
    convening of the panel.
    (d) The chairman shall ensure that before the panel gives its
    expert opinion under section 22 of this chapter, each panel
    member has the opportunity to review every item of evidence
    submitted by the parties.
    (e) Before considering any evidence or deliberating with other
    panel members, each member of the medical review panel shall
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 12 of 19
    take an oath in writing on a form provided by the panel
    chairman, which must read as follows:
    “I (swear) (affirm) under penalties of perjury that I will well
    and truly consider the evidence submitted by the parties; that I
    will render my opinion without bias, based upon the evidence
    submitted by the parties, and that I have not and will not
    communicate with any party or representative of a party
    before rendering my opinion, except as authorized by law.”.
    
    Ind. Code § 34-18-10-17
    .
    After reviewing all evidence and after any examination of the
    panel by counsel representing either party, the panel shall, within
    thirty (30) days, give one (1) or more of the following expert
    opinions, which must be in writing and signed by the panelists:
    (1) The evidence supports the conclusion that the defendant
    or defendants failed to comply with the appropriate standard
    of care as charged in the complaint.
    (2) The evidence does not support the conclusion that the
    defendant or defendants failed to meet the applicable standard
    of care as charged in the complaint.
    (3) There is a material issue of fact, not requiring expert
    opinion, bearing on liability for consideration by the court or
    jury.
    (4) The conduct complained of was or was not a factor of the
    resultant damages.
    
    Ind. Code § 34-18-10-22
    . This issue boils down to whether Fair’s proposed
    complaint was sufficient to preserve a claim against Ball Memorial’s
    pharmacist, even though negligence by neither the pharmacist nor any member
    of the pharmacist’s staff was specifically alleged in the proposed complaint.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 13 of 19
    Analysis
    [19]   Much of the discussion of this issue revolves around two cases, with Ball
    Memorial relying on this court’s holding in K.D., 
    951 N.E.2d at 855
    , while Fair
    and the ITLA argue that K.D. is in conflict with the Act and the Indiana
    Supreme Court’s opinion in Miller, 679 N.E.2d at 1329. Because we need not
    rely on K.D. to reach our conclusion on this issue, we leave the question of
    K.D.’s validity for another day.1
    [20]   In Miller, Nicholas Miller and his parents brought suit against Dr. Herbert
    Schiller and Memorial Hospital of South Bend (“the Hospital”) for injuries
    sustained at or around the time of Nicholas’s June 7, 1982, birth. Id. at 1330.
    Dr. Schiller’s negligent actions were alleged to have taken place “‘on or about
    June 1, 1982’” while the Hospital’s negligent acts were alleged as occurring
    “‘on and after June 7, 1982[.]’” Id. After presenting the proposed complaint to,
    and obtaining an opinion from a medical review panel, the Millers filed suit in
    trial court. Id. After the Millers settled with Dr. Schiller, the Hospital moved
    for summary judgment, arguing, inter alia, that the injuries allegedly sustained
    by Nicholas due to the actions of Dr. Schiller and/or the Hospital were
    identical. Id. at 1331. When the Millers responded that their claims against the
    Hospital were only for its alleged post-natal negligence, while their claims
    against Dr. Schiller were for his pre-natal negligence, the Hospital countered
    1
    The parties also argue about the application to this case of this court’s decision in Stafford v.
    Szymanowski, 
    13 N.E.2d 890
     (Ind. Ct. App. 2014), trans. pending. On February 5, 2015, the Indiana
    Supreme Court granted transfer in Stafford, and it therefore has no precedential value.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015                       Page 14 of 19
    that no distinction between pre- and post-natal negligence had been made the
    medical review panel. 
    Id.
     After the trial court granted summary judgment to
    the Hospital, the Millers appealed. 
    Id.
    [21]   The Miller court first noted that there is no dispute that, if there are two separate
    acts of medical malpractice that cause distinct injuries, there may be two
    recoveries. Id. at 1332. The court then explained the general principles of
    notice pleading that are used in Indiana:
    The principles of notice pleading are utilized in Indiana. Our
    rules require that “all pleadings shall be so construed as to do
    substantial justice, lead to disposition on the merits, and avoid
    litigation of procedural points.” Ind. Trial Rule 8(F).
    Specifically, Indiana Trial Rule 8(A) requires only “(1) a short
    and plain statement of the claim showing that the pleader is
    entitled to relief, and (2) a demand for the relief to which the
    pleader deems entitled....” This rule “is designed to discourage
    battles over mere form of statement and to sweep away needless
    controversies that have occurred either to delay trial on the
    merits or to prevent a party from having a trial because of
    mistakes in statement.” 1 William F. Harvey, Indiana Practice,
    Rule 8(a) (2d ed. 1987). Our notice pleading rules do not require
    that the complaint state all the elements of a cause of action.
    State v. Rankin, 
    260 Ind. 228
    , 231, 
    294 N.E.2d 604
    , 606 (Ind.
    1973). A plaintiff “essentially need only plead the operative facts
    involved in the litigation.” Id. at 231, 294 N.E.2d at 606.
    Miller, 679 N.E.2d at 1332.
    [22]   The Miller court reversed the trial court’s grant of summary judgment to the
    Hospital, concluding that the Millers’ proposed complaint was sufficient to
    preserve separate claims against Dr. Schiller and the Hospital. Id. The court
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 15 of 19
    noted that the complaints filed by the Millers contained separate counts for
    each defendant and specified different dates for each defendant’s alleged acts of
    malpractice. Id. The court concluded that “[w]hile a medical malpractice
    plaintiff must, as a prerequisite to filing suit, present the proposed complaint for
    review and expert opinion by a medical review panel, there is no requirement
    for such plaintiff to fully explicate and provide the particulars or legal
    contentions regarding the claim.” Id.
    [23]   The application of Miller to this case leads us to conclude that Fair may pursue
    a claim of negligence against Ball Memorial’s pharmacist in the trial court. As
    mentioned, the Miller court’s disposition was based on the principles of notice
    pleading, which do not require that a complaint state all of the elements of a
    cause of action or anything more than the “‘operative facts involved in the
    litigation.’” Miller, 679 N.E.2d at 1332 (quoting State v. Rankin, 
    260 Ind. 228
    ,
    231, 
    294 N.E.2d 604
    , 606 (Ind. 1973)). Fair has satisfied Miller’s requirements.
    As previously mentioned, Fair’s proposed complaint alleged, inter alia, that Ball
    Memorial’s “nurses and staff failed to properly administer medications and
    [monitor] the effects of the medication[.]” Appellant’s App. p. 77 (emphasis
    added). It is not disputed that Ball Memorial’s pharmacist is a member of the
    hospital’s staff. Moreover, because “administer” may be defined as “to mete
    out [or] dispense[,]” WEBSTER’S THIRD NEW INTERNATIONAL DICTIONARY 27
    (Phillip Babcock Gove et al. eds., G.&C. Merriam Company 1964), Ball
    Memorial’s pharmacist was involved in the administration of the medications
    to Dickey. In other words, Ball Memorial was put on notice that the possible
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015      Page 16 of 19
    negligence of any member of its staff involved in the administration of the
    medications was at issue, which includes the pharmacist. The trial court
    correctly denied Ball Memorial summary judgment on this point.
    II. Dr. Yazgan and Meridian Services’ Claim
    Against the Pharmacist
    [24]   While Dr. Yazgan and Meridian Services took no position on whether Fair
    may be allowed to pursue a claim against Ball Memorial’s pharmacist, they
    argue that the resolution of that question does not affect their right to raise his
    possible negligence as a defense, even though they did not raise the issue before
    the Panel. Ball Memorial agrees that a medical malpractice defendant has no
    responsibility to identify claims or defenses to a medical review panel. Because
    Fair does not dispute this, we need not address it further. However, because the
    merits may be addressed quickly, we choose to do so.
    [25]   The Act places the burden on a medical malpractice plaintiff to bring claims
    before a medical review panel, see 
    Ind. Code § 34-18-8-4
    (1), but no similar
    burden is placed on defendants to present defenses.
    Necessarily, the initial burden falls upon the party submitting the
    proposed complaint. Without evidence from the complainant in
    support of the proposed complaint the review panel is unable to
    “express its expert opinion as to whether or not the evidence
    supports the conclusion that the defendant or defendants acted or
    failed to act within the appropriate standards of care as charged
    in the complaint.” Only when the complainant’s evidence is
    submitted is the defendant in the proposed complaint compelled
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015    Page 17 of 19
    to come forward with evidence in response to the complainant’s
    evidence.
    Galindo v. Christensen, 
    569 N.E.2d 702
    , 705-06 (Ind. Ct. App. 1991) (citation
    omitted). Because Dr. Yazgan and Meridian Services had no burden to place
    allegations of pharmacist negligence before the panel, they are not precluded
    from presenting such evidence in the trial court.
    III. Ball Memorial’s Vicarious Liability
    [26]   Ball Memorial contends that its potential liability in this case should be limited
    to vicarious liability for the alleged negligence of Dr. Yazgan or Meridian
    Services, which is limited by the Act to $250,000.00. Dr. Yazgan and Meridian
    Services take no position on this issue, other than to emphasize that any
    disposition should not affect their right to present their defense. Fair contends
    that the issue is not yet ripe for adjudication.
    [27]   Indiana Code section 34-18-14-3(d) provides as follows:
    (d) If a health care provider qualified under this article (or IC 27-
    12 before its repeal) admits liability or is adjudicated liable solely
    by reason of the conduct of another health care provider who is
    an officer, agent, or employee of the health care provider acting
    in the course and scope of employment and qualified under this
    article (or IC 27-12 before its repeal), the total amount that shall
    be paid to the claimant on behalf of the officer, agent, or
    employee and the health care provider by the health care
    provider or its insurer is two hundred fifty thousand dollars
    ($250,000). The balance of an adjudicated amount to which the
    claimant is entitled shall be paid by other liable health care
    providers or the patient’s compensation fund, or both.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015      Page 18 of 19
    [28]   Fair is correct that this question is not yet ripe for adjudication. Because the
    question of negligence by Ball Memorial’s pharmacist is still open, Ball
    Memorial is not entitled to an order limiting its potential liability to vicarious
    liability for the actions of Dr. Yazgan and Meridian Services.
    Conclusion
    [29]   We conclude that the trial court correctly denied defendant Ball Memorial
    summary judgment on the question of whether plaintiff Fair may pursue a
    negligence claim against its pharmacist. Dr. Yazgan and Meridian Services
    may also raise potential negligence on the part of the Ball Memorial pharmacist
    as a defense. Because Fair has a claim of negligence against the Ball Memorial
    pharmacist, Ball Memorial is not entitled to an order limiting its liability
    pursuant to Indiana Code section 34-18-14-3(d) at this time.
    [30]   We affirm the judgment of the trial court.
    Najam, J., and Mathias, J., concur.
    Court of Appeals of Indiana | Opinion 18A02-1405-CT-316 | March 2, 2015   Page 19 of 19